Morning speech therapy benefits young people with childhood apraxia
· News-MedicalFor young people with childhood apraxia of speech (CAS), a disorder that affects the brain's ability to plan and coordinate the movements needed for speech, speech difficulties can persist well beyond childhood. Unlike many childhood speech disorders that improve with age, people with childhood CAS may continue to experience speech errors into adolescence and young adulthood and often require intensive, individualized therapy.
CAS affects an estimated 0.1% to 0.2% of the population and can make it difficult for children to produce sounds and words accurately and consistently. About 78% of adolescents with CAS continue to make speech errors in conversation, while 65% experience reading difficulties, potentially affecting their academic performance, social interactions and confidence. Treatment also can be intensive, with children with CAS requiring substantially more individualized intervention than children with other speech sound disorders to achieve comparable outcomes.
New research from Florida Atlantic University's College of Education is examining whether when speech therapy occurs could influence how effectively adolescents and young adults with CAS learn and retain new speech patterns. The study explores the role of time of day and memory in speech-motor learning, with the goal of identifying strategies that could ultimately help clinicians optimize treatment for people with CAS.
To investigate how people with and without CAS learn and retain new speech patterns, researchers recruited 82 adolescents and young adults ages 12 to 21, including participants with long-standing CAS and peers with typical speech profiles. Participants first learned to recognize two Danish vowel sounds that do not occur in English and then practiced producing them.
Participants were divided into two groups: one trained in the morning and the other in the evening. Researchers measured how accurately participants produced the unfamiliar sounds immediately after training and again 12 hours later. Native Danish speakers evaluated the participants' productions, allowing researchers to track changes in speech accuracy over time and determine whether the timing of training influenced how newly learned speech patterns were retained.
The study, published in the journal Clinical Linguistics & Phonetics, revealed a striking difference in how speech-motor learning unfolded for participants with and without CAS. Among participants with typical speech profiles, those who trained in the evening showed slight improvements in their ability to produce the unfamiliar Danish vowels after 12 hours, while those who trained in the morning showed a decline in accuracy over the same period. The finding is consistent with previous research suggesting that evening training may give typical learners an advantage in retaining newly learned speech patterns, potentially because sleep soon after training helps consolidate what they have learned.
The pattern, however, was reversed among participants with long-standing CAS. Those who trained in the morning consistently outperformed those who trained in the evening – both immediately after training and 12 hours later. This suggests that, unlike their peers with typical speech, adolescents and young adults with CAS may not receive the same benefit from an overnight period following speech-motor training.
The researchers also conducted standardized speech assessments to examine how CAS continued to present in adolescence and young adulthood. They found that participants with CAS differed from their peers across multiple measures of speech production, even though the groups did not differ in phonological processing, suggesting that the characteristic speech difficulties associated with CAS can remain clinically observable well beyond childhood.
Together, the findings point to a different pattern of speech-motor learning and consolidation in people with long-standing CAS. The results raise the possibility that the timing of speech intervention could influence how effectively individuals with CAS learn new speech patterns, potentially providing clinicians with a simple way to optimize treatment. The researchers note, however, that the role of sleep remains a hypothesis that requires further study.
Anne L. van Zelst, Ph.D., senior author, a speech-language pathologist, assistant professor in Communication Sciences and Disorders within FAU's College of Education, and faculty member of FAU's Stiles-Nicholson Brain InstituteWhat's particularly exciting about these findings is that the timing of speech practice appears to matter differently for people with and without childhood apraxia of speech. For individuals with long-standing CAS, morning training produced more consistent benefits, suggesting that we may eventually be able to use what we know about learning and memory to make speech treatment more effective without simply adding more hours of therapy. If we can identify when the brain is most prepared to learn and retain new speech patterns, we could potentially reduce some of the treatment burden for individuals who have been working on their speech for years."
Study co-author is F. Sayako Earle, Ph.D., an associate professor of Communication Sciences and Disorders at the University of Delaware.
The research was funded by the National Institutes of Health, National Institute on Deafness and Other Disorders, awarded to Earle.
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